July 2005—During a February hearing on harm reduction conducted by the U.S. House Sub-committee on Criminal Justice, Drug Policy and Human Resources, Malaysian healthcare figures submitted testimony asserting that because drugs are intoxicants and are forbidden under Islam, Islamic law is fundamentally incompatible with harm reduction efforts such as syringe exchange. In response to this testimony, Dr. Adeeba Kamarulzaman, chief of the infectious diseases unit at the University of Malaya Medical Center and a member of the TREAT Asia steering committee, provided a detailed and eloquent rebuttal of these claims. Her written testimony is excerpted below; the full text is available online atwww.TREATAsia.org.

Dr. Adeeba Kamarulzaman

As an HIV/AIDS physician practising in Malaysia and a Muslim, I wish to clarify some of the statements made... with respect to the problem of drug use in the region and Islam’s perspective on these issues….In many parts of Asia unsafe injecting practices have been the primary risks driving the explosive HIV/AIDS epidemic, and Malaysia is no exception. Despite having one of the toughest laws in the world for drug use and trafficking over the last five decades, illicit drug use remains a major problem….In recent years the problem of unsafe injecting drug use has led to an exponential rise in the reported number of HIV and AIDS cases, of which 7 percent are injecting-drug-use-related. Since the mid-1990s an estimated 4,000 new HIV infections related to injecting drug use are reported annually in Malaysia.

[Earlier testimony] indicated that drugs are a form of intoxicant and are forbidden for all Muslims, and that harm reduction programs are against the national policies and religions of Asian countries. Drugs and indeed alcohol are haram (forbidden) for all Muslims as Islam forbids any action that would result in harm or destruction. However, beyond the simple haram and halal of substances such as drugs and alcohol lie the fundamental objectives of Islamic divine laws, which are the protection and preservation of the faith, life, intellect, progeny, and wealth….Harm reduction can therefore be accepted as a necessity in order to preserve [these things], which are threatened by the twin epidemics of drug use and HIV/AIDS. In Islam, life and good health must be protected and promoted in all circumstances and this includes prevention and treatment of any illness and disease. In this regard, the numerous harms associated with drug addiction, a chronic medical condition, should be prevented through measures that have been scientifically proven….

The principle of injury in Islam (darar) asserts that no one should be hurt or cause hurt to others (la darara wa la dirar). Drug addiction and HIV/AIDS hurt patients and their family in their life and health. The law requires that any injury should be mitigated to the extent possible. A legal dictum in Islam gives the provision that “a lesser harm may be tolerated in order to eliminate a greater harm.” Harm reduction programs, for which there is compelling scientific evidence…[are] therefore not against Islamic principles. The aforementioned legal dictum in Islam stresses the need to choose the lesser of two evils. It is of greater harm for Muslims to allow more injecting drug users and their family members to be infected with HIV/AIDS than it is for them to allow a harm reduction program to take place.

Finally, in Islam public interest takes precedence over personal interest. A relevant legal dictum in the context of harm reduction is that “a particular harm may be tolerated in order to prevent harm to the general public.” This means that whenever a conflict between personal and public interests arises, harm to the former may be tolerated so as to protect the latter.